Actor Ben Stiller Survived Aggressive Prostate Cancer At Age 48; Now He’s Directing A New Television Show ‘Severance’ on Apple TV

When Stiller — famous for his starring roles in Zoolander, Meet the Parents and Tropic Thunder — went public about his battle with the disease, he did so with a message about the importance of early screening for prostate cancer. But the way in which Stiller discovered his prostate cancer the PSA test is something about which some doctors disagree.

Ben Stiller's Prostate Cancer Diagnosis

In a 2016 appearance on The Howard Stern Show, Ben Stiller shared that he was diagnosed with prostate cancer in June 2014 at age 48. He is now 56 years old.

He spoke about how the American Cancer Society recommendations suggest that average-risk men begin screening for the disease at age 50. (It remains unclear at what type of risk Stiller was of developing prostate cancer.) He also pointed out that had he followed the recommendations, his cancer would not have been detected. Stiller credits his doctor's initiative to begin administering the test early, and the effectiveness of the PSA (prostate-specific antigen) test with saving his life.

"The PSA test is the only early screener for prostate cancer and, right now, the United States Preventive Services Task Force does not recommend (taking) the test," Stiller said in the 2016 interview. "I think the American Cancer Society says you should discuss it at 50. If I hadn't taken the test my doctor started giving it to me at 46 I would not have known. Right now, I still wouldn't have known."

Stiller had surgery to remove his cancer, and was declared cancer-free shortly thereafter. But, he said, his message is still important: Even though the ACS recommendation is to begin screening at age 50, men should have a conversation about when is the best time to start with their doctors. Higher-risk men may have to start earlier.

For example, men of certain ethnicities, such as Black men, are at a higher risk of developing prostate cancer, so, a doctor may opt to begin testing in the mid-40s. Men with a family history of prostate cancer may also want to consider screening early.

Screening is typically done with the PSA test. PSA is a protein secreted by the prostate gland; a large amount of PSA in a person's body can indicate that cancer cells are growing. But that is not always the case. (For example, if a man has an elevated PSA level, he has somewhere between a 20% to 40% chance of having cancer.)

Problems With the PSA Test

"The problem with PSA testing is that it's not totally specific for prostate cancer," Dr. James Brooks, a urologic oncologist at Stanford Medicine, tells SurvivorNet. "It can also reflect enlargement of the prostate, which most men get at some point in their lifetime."

It can also be a product of infection or inflammation, he adds.

PSA Test is Not Perfect But it is Helpful

The point is that the PSA test is not a perfect test, says Dr. Edwin Posadas, director of the Translational Oncology Program at Cedars-Sinai Medical Center in Los Angeles.

The PSA test is more controversial when it comes to using it to detect prostate cancer in older men. This is because most men will develop prostate cancer at some point in their lives if they live long enough, Dr. Geoffrey Sonn, assistant professor of urology at Stanford Medicine, tells SurvivorNet. But most men will not die from prostate cancer.

In addition, because prostate cancer is such a slow-growing type of cancer, it is much more likely that older men will die of something other than prostate cancer.

The United States Preventive Services Task Force is an independent panel of experts that reviews the effectiveness and develops recommendations for clinical preventive services. Like Ben Stiller pointed out, this group recommends that for men ages 55 to 69, the decision to undergo periodic PSA-based screening for prostate cancer is a personal one and should be made in consultation with a doctor. There are no screening recommendations for men younger than 55, like Stiller was at the time.

However, the task force recommends against this form of testing for men aged 70 and older.

When Should I Get Tested for Prostate Cancer?

The task force states its recommendation is based on the fact that many men will experience potential harm from screening using the PSA-based test.

Dr. Jim Hu, a urologic oncologist at Weill Cornell Medicine, reiterates this point, "There are harms of PSA testing, because you may over-diagnose, or you may find prostate cancers in men who were more likely to die of something else, or that you would subject these men to biopsies which are uncomfortable, and have about a 2 percent to 3 percent risk of a serious infection."

However, the test is not all bad; experts agree that some valuable information can be gained from the PSA test. But its role in detecting prostate cancer remains a highly debated topic. If you think this test is right for you, talk to your doctor.

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